DefinitionA hip fracture is another term for a broken hip. It is a complete or partial break in the top part of the thighbone. The thighbone, also called the femur, inserts into the hip joint. Broken hips occur more often in older people. In 1996 around 15,000 Australians sustained hip fractures. It is predicted that by 2006 the total number of hip fractures will have incresed by 36% to 21,000 per year. About 50% of cases occur in people age 80 or over.

What are the signs and symptoms of the injury?The signs and symptoms of a broken hip include:

severe pain in the hip or groin

swelling, tenderness, and bruising in the hip area

deformity of the hip

turning outward of the affected leg

shorter length of the affected leg

inability to move the affected leg due to pain

What are the causes and risks of the injury?A broken hip is most often the result of an injury. Falls and car accidents are the most common sources of these injuries. Bone cancer can also weaken the hip. Another cause of hip fractures is osteoporosis, a disease that causes a slow decrease in bone density. This condition can weaken the hip and make it more likely to break. Poor nutrition, especially a diet lacking in calcium, increases the risk of osteoporosis. Smoking also makes a person more prone to this disease.

What can be done to prevent the injury?To prevent a broken hip a person should:

try to maintain bone density by eating a balanced diet containing adequate calcium and protein, and by quitting smoking

guard against falls

use a cane or walker if unsteady

Also, women past the age of menopause should consider taking oestrogen or other medications that help prevent bone loss.

How is the injury recognised?The person will have a physical examination and give a medical history. This will give the doctor an idea if the hip is broken. The diagnosis can be confirmed with a joint X-ray.

What are the treatments for the injury?Treatment will depend on the location, type, and severity of the fracture. Individuals must also be checked for other medical problems to see if they can handle the stress of surgery.

Many hip fractures will need immediate surgery, known as a hip pinning. Leg traction, which is a pulling pressure applied to the leg, may be used before surgery. During surgery, the broken bone parts are put back in place. Often, they are secured with special metal pins. In some cases, part or all of the hip joint needs to be replaced with an artificial joint. Analgesia is given to control pain if needed.

What are the side effects of the treatments?Long periods of bed rest can be harmful for elderly people with broken hips. This puts individuals at greater risk for blood clots and lung infections such as pneumonia. Surgery and anaesthesia also carry risks. These include bleeding, infection and allergic reactions to the drugs used for pain.

What happens after treatment for the injury?Physiotherapy may be needed after surgery or cast removal. The person will need to use a walker or crutches at first. Many people make a full recovery after surgery.

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